Reumatizam, Vol. 64 No. 2, 2017.
Original scientific paper
DISCONTINUATION OF BIOLOGICS IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS AFTER ACHIEVING CLINICAL REMISSION: EXPERIENCE OF THE REPUBLIC OF CROATIA REFERRAL CENTER FOR PEDIATRIC AND ADOLESCENT RHEUMATOLOGY
Marija Jelušić
Karla Jurić
Marijan Frković
Kristina Potočki
Nenad Vukojević
Sanja Perić
Dubravko Bajramović
Vlatko Duspara
Abstract
Aim: To determine the duration of clinical remission under biologics and the risk of relapse aft er discontinuation of their application in patients with JIA. Patients and methods: Retrospective collection of medical records of JIA patients treated with biologics at the Referral Center for Pediatric and Adolescent Rheumatology of the Republic of Croatia Ministry of Health during the period from 2010 to 2015, in whom biological therapy was discontinued aft er achieving clinical remission.
Results: Th e biologics (anti TNF, anti IL-6, anti IL-1) were used in 71 patients with JIA. In 17 patients (23.9%) the biologics were discontinued aft er achieving clinical remission aft er an average treatment duration of 27 months (1–60). The average monitoring time aft er the discontinuation of biologics was 24 months (12–59). Early relapses were observed in 5/17 patients (29.4%) during the first 6 months of therapy discontinuation, while in one patient (5.8%) there was a relapse in the 6- to 12-month monitoring period. Eleven patients (64.7%) remained in remission throughout the monitoring period.
Conclusion: Th e introduction of biologics into the therapy is clearly defined in recent guidelines for JIA treatment. On the other hand, discontinuing their use aft er achieving clinical remission is still based on the experience and judgment of pediatric rheumatologists. Therefore, the development of appropriate guidelines with defined time and mode
of discontinuation of biological therapy is one of the essential goals in the treatment and monitoring of JIA patients.
Keywords
Arthritis, juvenile – drug therapy; Biological products – therapeutic use; Treatment outcome; Remission induction; Recurrence; Time factors
Hrčak ID:
198812
URI
Publication date:
29.3.2018.
Visits: 4.960 *